Salivary gland cancer: causes, symptoms and treatment

Definition of salivary gland cancer

What is salivary gland cancer?

Salivary gland cancer is a type of cancer that occurs in the salivary glands. The salivary glands themselves function to produce saliva, which is a lubricating fluid in the mouth and throat. This saliva contains enzymes that help the body break down food nutrients.

Not only that, saliva is also useful as an antibody to prevent infection of the mouth and throat.

The salivary glands consist of 3 main glands, including:

• Parotid gland. The largest salivary glands are located in front of the ear. Nearly many cases of cancer start in this gland.
• Submandibular glands. Glands smaller than the parotid under the jaw. This is the second most common area where cancer begins.
• Sublingual glands. Small glands under the tongue. Both tumors and cancer are rare in this gland.

There are also many tiny minor salivary glands that are located under the lining of the lips, tongue, roof of the mouth, or the inside of the cheeks. Tumors or cancer very rarely appear in these glands. However, if abnormal cells appear, they are likely to develop into cancer at a later date.

How common is this disease?

Salivary gland cancer is a type of cancer that is quite rare, compared to other types of cancer, such as breast cancer, lung cancer, or cervical cancer. Even so, some people with certain conditions or have certain factors may be at higher risk for this disease.

Types of salivary gland cancer

It turns out that salivary gland cancer has different types, including:

Mukoepidermoid carcinoma

Mukoepidermoid carcinoma is the most common type of cancer. It mostly starts in the parotid gland, and very rarely it occurs in the submandibular glands or minor salivary glands in the mouth.

Adenoid cystic carcinoma

Adenoid cystic carcinoma is usually slow growing and has a lower appearance than other cancer cells when viewed under a microscope. Cancer cells are also difficult to completely remove because they tend to spread along the nerves. That is why this type of salivary gland cancer can come back years after being treated.

Adenocarcinoma

Adenocarcinoma is a type of cancer used to describe cancer that starts in glandular cells (cells that normally secrete substances). This type of cancer is further divided into several types, namely salty cell carcinoma, oncostic carcinoma, and other rare types of cancer.

Signs & symptoms of salivary gland cancer

What are the symptoms of salivary gland cancer?

Symptoms of salivary gland cancer that generally occur are:

• A lump in the neck or swelling near the jaw or around the mouth.
• Numbness in part of the face.
• Weakness of the muscles on one side of the face.
• Stubborn pain in the salivary gland area.
• Difficulty swallowing
• Difficulty opening your mouth wide.

A lump or swollen area near the salivary gland is the most common sign of a salivary gland tumor, but it doesn't mean you have cancer. The reason is, not all tumors are malignant or can grow to spread and damage the surrounding tissue.

When to see a doctor?

If you experience the signs and symptoms of cancer mentioned above, see a doctor immediately. The sooner it is detected, the easier the treatment will be. This also affects the quality of life of the sufferer.

Causes of salivary gland cancer

The causes of salivary gland cancer are not fully known by experts. However, most cancers occur because cells have mutated so that they grow and divide rapidly.

These cells will continue to live, even though the cycle programmed in healthy cells is dead. These abnormal cells will accumulate and form tumors. Over time, cancer cells will spread and damage the surrounding tissue.

Not only that, cancer cells can break apart and spread (metastasize) to distant areas of the body.

Risk factors for salivary gland cancer

Salivary gland cancer can affect anyone. However, some people can have a higher risk of this disease than others because of various factors, as reported by the Cleveland Clinic:

• Are over 55 years of age. The risk of cancer in the mouth generally increases with age.
• Having radiotherapy to the head or neck area or being exposed to radioactive substances.
• Have a habit of smoking and drinking excessive alcohol.
• Work in certain jobs, including plumbing, manufacturing rubber products, or mining asbestos.
• Have had Warthin's tumor, which is a benign tumor in the salivary glands that usually affects smokers.

Diagnosis & treatment of salivary gland cancer

The information provided is not a substitute for medical advice. ALWAYS consult your doctor for more information.

How to diagnose salivary gland cancer?

In order to diagnose cancer of the salivary glands, your doctor will ask you to undergo a series of medical tests, including:

• Physical examination. The doctor will check your jaw, neck, and throat for lumps or swelling.
• Imaging test. Imaging tests, such as MRIs and CT scans, can help your doctor determine the size and location of your salivary gland cancer.
• Collection of tissue samples for testing. Your doctor may recommend collecting a tissue sample (biopsy) for laboratory tests. In an aspiration biopsy, the doctor inserts a needle into the suspect area and removes fluid or cells. Salivary gland tumors are also analyzed in the laboratory after surgery to confirm the diagnosis.

Once cancer is diagnosed, the doctor will determine the level (stage) of your cancer. The stage of your cancer determines your treatment options and gives your doctor an overview of your prognosis.

What are the treatments for salivary gland cancer?

Treatment for salivary gland cancer depends on the type, size, and stage of the cancer you have as well as your overall health and preferences. The following is a common treatment for cancer of the salivary glands:

Operation

Surgery is often the mainstay of treatment for salivary gland cancer. This is because the cancer cells can be completely removed. Not only the salivary glands, sometimes the nearby soft tissue is also removed if affected.

The goal is that there are no more cancer cells on the outer edge (margin) of the tumor that is removed so that the cancer does not recur.

Surgical removal of the parotid gland

Most cancers occur in the parotid gland. This surgery is somewhat difficult to perform because it is close to the facial nerve, which controls facial movements. For this, an incision is made in the skin in front of the ear and can extend to the neck.

Most parotid gland cancers start on the outside of the gland, which is called the superficial lobe. To fix this, the doctor will only remove the lobe and this procedure is known as superficial parotidectomy. This procedure keeps the facial nerve intact and does not affect facial movements.

If your cancer has spread to deeper tissues, the surgeon will remove the entire gland. This operation is called a total parotidectomy. If the cancer has developed into the facial nerve, it must be removed as well.

But before medical action is carried out, the doctor will first consider the benefits and side effects.

Surgical removal of the submandibular or sublingual gland

If your cancer is in the submandibular or sublingual gland, the surgeon will make an incision in the skin to remove the entire gland and possibly some of the surrounding tissue or bone.

The nerves that pass through or near these glands control movement of the tongue and lower part of the face, as well as sensation and taste. Depending on the size and location of the cancer, the surgeon may need to remove some of these nerves.

Minor salivary gland surgery

Minor salivary gland cancer can occur on the lips, tongue, palate (palate), mouth, throat, voice box (larynx), nose, and sinuses. The surgeon usually removes some of the surrounding tissue along with the cancer by making an incision in the skin.

Radiation therapy

Radiation therapy uses high-power beams of energy, such as X-rays, to kill cancer cells. During radiation therapy, you lie on a table while a machine moves around you, emitting high-powered beams to specific points on your body.

This therapy can be used after surgery to kill any remaining cancer cells.

If surgery is not possible because the tumor is very large or its location makes removal too risky, radiation alone can be used to treat glandular cancer tumors.

Side effects of radiotherapy are skin rash, nausea, vomiting, body fatigue, and difficulty swallowing. Sometimes, these side effects will go away on their own over time.

Chemotherapy

Chemotherapy is a drug therapy that uses chemicals to kill cancer cells. Either of these treatments may be an option for people with advanced salivary gland cancer that has spread to distant areas of the body. Therefore, chemotherapy is not used as the main treatment.

Some drugs to treat salivary gland cancer, which are commonly used in chemotherapy are:

• Cisplatin.
• Carboplatin.
• Doxorubicin (Adriamycin®).
• 5-fluorouracil (5-FU).
• Cyclophosphamide (Cytoxan®).
• Paclitaxel (Taxol®).
• Docetaxel (Taxotere®).
• Vinorelbine (Navelbine®).
• Methotrexate.

Side effects that may occur during chemotherapy are hair loss, decreased appetite, nausea and vomiting, and fatigue.

Treatment of salivary gland cancer at home

In addition to treatment at the hospital, cancer patients are required to follow home care, namely by adopting a healthy lifestyle for cancer sufferers. The goal is to support the effectiveness of the treatment being carried out. Some of the things that are usually done are:

• Stay active and carry out regular exercise in accordance with the doctor's direction.
• Follow a diet that is applied by doctors and nutritionists so that nutritional needs are fulfilled and of course can maintain overall body health.
• Get enough sleep and reduce stress with meditation, breathing exercises, or doing activities that you enjoy.
• Follow treatment on schedule and do not miss doses of medication if prescribed.

Prevention of salivary gland cancer

The cause of salivary gland cancer is not known with certainty, because there is no completely effective way to prevent this cancer. Even so, health experts recommend several ways to reduce the risk of disease, such as:

• Quit smoking and avoid secondhand smoke in the environment. The reason is, one of the risks of this type of cancer, namely Warthin's tumor usually attacks smokers.
• Limit alcohol use. Talk to your doctor about the safe amount of alcohol consumption.
• Always wear protective gear, such as gloves or a mask, if you work in a factory.
• Increase consumption of fruits, vegetables, whole grains, or nuts. Limit foods that contain preservatives, are high in sugar, fat, or salt.